RESUMO
A case is reported of autoimmune thrombocytopenic purpura in a narcotics addict with antibodies against human immune deficiency virus (HIV). Three points need stressing: 1) HIV is a new viral cause of autoimmune thrombocytopenic purpura, the first report of which dates from 1985; 2) this bleeding diathesis may be seen more often in normal anaesthetic practice because of the frequent association of intravenous toxicomania with anti-HIV antibodies and thrombocytopaenia. Thus, of the thirty cases detected in two years and followed by our Department of haematology, two were operated on in the orthopaedic unit; 3) the use of intravenous human gammaglobulins is of great interest each time the clinical situation requires a rapid increase in the platelet count, such as before surgery. The usual dose is 400 mg . kg-1 . j-1 for five consecutive days. The response to immunoglobulins is seen in two or three days; their efficacy, in the case described, lasted for five to seven days, this including the postoperative time. Booster doses were followed by a quick increase in platelet count.
Assuntos
Complexo Relacionado com a AIDS/complicações , Doenças Autoimunes/terapia , Fraturas do Quadril/cirurgia , Imunização Passiva , Púrpura Trombocitopênica/terapia , Adulto , HIV/imunologia , Dependência de Heroína , Humanos , Masculino , Cuidados Pré-Operatórios , EsplenectomiaRESUMO
Mönckeberg's sclerosis is characterized by medial arterial calcifications. This disease usually occurs in old people and the lesions are observed in distal lower limb arteries. The evolution is generally asymptomatic. The other arteries are uncommonly affected. This report concerns a patient with exceptionally extensive disease and simultaneous asymptomatic arterial hypertension. Blood pressure measured non invasively represents the force required to compress the brachial artery, and not the real blood pressure. In such patients, blood pressure should be monitored during anaesthesia through arterial cannulation.